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senator reid spoke with reporters in nevada about his comments. . . in effect, he said i have known you for a long time.

anyone you want me to talk to, i would be happy to. we have a lot to do. i have spent of the last couple of weeks hours over the telephone with the president and others working on health care. i spent a long time with him yesterday and will continue to do so. i continue to do my very best for the people of nevada and this country. >> some have commented that you have not -- and that you are uncomfortable. how do you feel about that? >> i really appreciate people writing nice things about me. there was a wonderful editorial in "the l.a. times" today. i am very proud of the fact and

can still remember the meeting that took place in my office with the center barack obama telling him that i thought he was going to be elected president. i am sure there were others that he was kind of surprised the democratic leader was calling the senator over to suggest to could be elected president. my conversations with the highest-ranking african- american in congress from south carolina. i got a call from merv who i observed with in congress to the other. -- who i served him with in congress together. i have apologized to the president, to everyone within the sound of my voice that i could use a better choice of

words. i will continue to keep doing my work. i was one of the leaders of the civil-rights movement in nevada. governor of callahan -- o 'callahan work to allow the integration of the gaming community in nevada. moving forward, i am very aware of the fact that the first african-american to serve in the federal court in the state of nevada was directly from the work i did. i recommended him to president clinton. the first university program -- i got a call last night. it was late and i was surprised at was awake from secretary salazar. he told me to make sure that i

should tell people that i have done more for diversity in the senate then everyone else put together. that is where we are and i'm going to more free to move forward to get health care done. -- and i am going to move forward. >> apologized to president obama and to community leaders. what about the voters? the implication is it that a dark skinned man that -- could not be here voted president? >> i have talked to leaders in the last few days. the african-american leaders in nevada have been wonderful. we know we have worked on together. the present majority leader of the senate here in nevada is one of my proteges and i am very proud of him and what we have been able to do together.

i'm not going to dwell on this any more. it is in the books. thank you all very much. >> the senate returns from recess next wednesday, january 20th. they will work on a judicial nomination in legislation to raise the federal debt limit. the house is back tomorrow at noon. legislative begins wednesday. democratic leaders in both chambers have to work out the differences in the two health care bills. it would to bring a single bill to the floor for voting. watch live house coverage on c- span, live senate debates on c- span2, and for update to visit the c-span.org. >> the increase in the last year alone, that is because we are

doing in number of things. i want to think michigan tech for trying to accommodate the large crowd and the video set up. thank you to the board and everyone here at michigan tech. when president obama can in in january, we were handed a lot of issues. congress said we will address them later and kick the can down the road. whether you agree with the president or not or even the democratically controlled congress, we have been tackling the issues and that has caused concerns. when president obama came into office, the economy was in a freefall and we were fighting two wars that we have not paid for. we have health care issues, chrysler, gm work in trouble. in his first year alone, one of the first bill we did was equal pay for equal work was because

women should be paid -- women should be paid the same as men. the make on average about 87 cents on the dollar during the same job for a man does. equal pay for equal work. that was signed into law. in february, we signed the extension of s-chip, the children health-care program. 10 million more people -- children are on that plan. we did thetarp. the loans to gm and chrysler. you name it and congress has tackled the. i am not saying everything we

we would get into that of the of it more. one other bill we did besides the economic recovery package to try and get the economy going and to get people back to work, move forward with our economy was just before we left in mid december. it was called the main street jobs bill. it came about as the stage for telling us -- as the states were telling us -- every five years -- a highway bill. we take money out of the trust fund to do roads, bridges, and transportation projects. that expired in october. they said they like the program because 80% is paid by the highway trust money and really have to match 20%. the economy throughout the nation is so poor that we cannot come up with the matching funds anymore. michigan left around $600

million on the table that we could not use because there was not a 20% madge. before we left in december was to pass the main street jobs bill. -- we could not do a 20% match. why do we take what we normally spend which is about $27 billion in a move it out of the trust. instead of having a matching fund it will be 100% paid for by the federal government. for every $1 billion you spend the estimate it preserves 23,000 jobs. that was the thought process. there were a couple other things in that bill like a revolving loan fund for water projects with about $47 million. there is another extension of unemployment in that

legislation, a 14 week extension. that bill passed. the senate is back next week. i expect them to take the bill up very soon. the president said he would like to see that passed by the end of january. it does not do us any good to wait until march, april, made to pass this bill and say, now try to do your construction projects. the jobs bill where we have 100% federal money using trust money to pay for these highway projects is a one-year program for 2010 only. we will do a five-year jobs bill after that and hopefully the states will be doing better. hopefully we can get people back working with construction and the industries associated. the matter and we have been doing, we talk about jobs, the

economy, and we were trying to work on ways to help them out. improving power lines, water, sewer, whenever it might be. no matter what aspect of our economy you look at, health care is a vital part. it is 16% of our economy. that is a big trunk. whether you are trying to employ people at your shop, manufacture parts, at michigan tech, what ever, the cost of health care is so expensive that no one can afford it. when we are looking at it, they pay more for every car they make -- they pay more for health insurance than every piece of steel that goes into that car. the cost has driven the cost of all products.

the cost has hurt as locally, hurts our families, nationally compared -- nationally, competitively. everything we do, healthcare has a role. i'm starting my 18th year in the congress. it is the one bill that that i have ever worked on that affects everyone. it affects everyone of us, from your first to your last breath. we find even with good health insurance you are just one disease away from bankruptcy. healthcare is a major part. i want to spend a lot of time on that then we will get into questions. before we go much further, let

me take a minute to think the men and women and families of the 1431 company that just came back from afghanistan. they were also in operation at iraqi freedom. no matter what you think of the wars, we owe those men, women, and their families a great debt of gratitude. the images the view some idea of the numerous military accolades the company earned their to under 31 missions performed in afghanistan. they earned 107 accommodations, 94 combat action badges, 26 bronze stars, and more than 34 purpleheart. these are all testaments to the courageous efforts these people

made on our behalf. they do not ask about the politics of the war. we owe them a great debt of gratitude. i hope you join me in the round of applause for the men and women who serve us. [applause] while they are deployed they have health care. all americans, i believe, should have health care. let's get into the health-care legislation. let me go through this power point. it is about 20 minutes. natalie have gone through committee through the house, the senate, it is now 39 slides. we do now that we have gone through committee. if you have any questions, i will try to go back and answer them. this is the size of my district. we are about 600 miles and one of the largest congressional

districts. some people said i have not done enough town hall meetings. everything from indian river to wnmu to read it simultaneous tv and radio in september. we also do the telephone town hall meetings. the first week in february will probably be the next one. philip the green card -- the orange card and we will get you on the call. -- fill out the card. i'm starting my fourth year of investigations into the insurance industry. it is an interest i have always had. these are some of the hearings we have had. you're going to hear about the medicare advantage. we did nursing home standards

and passed the law 25 years ago and have never had a hearing on that. long-term care insurance, are consumers protected? june 16th, termination of individual health insurance policies. if you are buying an individual family policy eiffel application, right? we had two hearings on this. when you fill up the insurance policy, most companies have about 1400 different codes. you go to the local drugstore in the fill up the prescription. if you trigger a code that will review your policy because with that code triggered might be very expensive medical treatment might be facing in the future and therefore they will jump you -- dump you. for instance, one family as they were filling out the form the

told him to put out he was 180 pounds but he was really 250 pounds. they dumped him and said he lied on his application. when it terminated from your health insurance policy, who do you appeal to? the company that just the end user you do not have a repeal rights. -- the company that just dumped you so you don't have repeal rights. they're all kinds of things. we did a couple hearings on that. insured, but not yet covered. you'll see when we talk about bankruptcy. most people file because of medical reasons. most of them have health insurance and their insurance doesn't cover anything. they are under insured.

the high cost of small business. businesses have told us repeatedly their number-one concern is to have good quality, dedicated employees they like to provide insurance to. there is the rates so high it that they cannot afford it. the purge them that way. it does not do employer any good to have a good, solid employee he testily is because they can no longer afford insurance. these are some of the hearings we have had. the house will 3962, the health care for america act. the annual premiums from 20002007 rose 70.2%. your wages over the same treated time when a 4.6%. you cannot afford it, government cannot afford it, businesses cannot afford it.

you cannot afford the increase. the average family health insurance policy now costs over $13,000 per year. the medium and come here is $38,000. -- the median income. that means 34% of your income before anything else. a price themselves out of the market. american journal of medicine reported that 62% of all bankruptcies in 2007 were related to medical expenses. 70% of those people have health insurance and thought they had coverage and thought they were fine. one illness, one accident away from bankruptcy. the average family policy is an extra thousand dollars per year -- is an extra $1,000.

one person dies every 12 minutes because they are denied access to health care. if it would have had health care, there would have had treatment and still be with us. -- they would have had treatment. we are the main committee that has jurisdiction over health care in the house. we worked on this writer to the first of the year. this was introduced on june 19th. all the interest groups were on the internet and took shots at it. we started on july 14th and amended it. there was another bill put on the internet. we started the committee markup. what i mean by markup is the amendment process. we start at 8:00 a.m. with for basically two weeks even though we did not meet. votes were taken were the committee was actually convened

july 16th-31st. brazil had 55 more minutes to go. congress had recess for august. we're still in committee. the chairman made an agreement with the republicans and basically said, let's take a report or to a vote on the bill and reported favorably to the floor? we will come back in september for the last 65 amendments. i did not vote for the bill because how you vote for a bill that is not done? how you favre believe this to the house if you are not done with your work? i was one of the few democrats that voted know. we came back on september 23rd and finished up the amendment. on october 29th, the combined couple bills, 3200 that became 3962.

the vote was held on november 7th. the vote on the house floor was 220-215. i voted for the final bill in the house of representatives not without some controversy. here is my concern with the bill. before, when i was doing these power points the boxes were not checked because we came out of committee. here is where i thought the committee fell short. i said the quality -- i will go back and talk about that a little more. those were my four concerned

when it came out of committee. those were all men in the house bill. the goals of health care improving quality, efficiency, controlling costs, affordability, accessibility, but shared investment, and work force. we have a health insurance that will change. you look at all the programs improved -- approved in the pick the option that is best for you and your family. what meets your individual needs? the government will not choose the policy for you. we have a marketplace for individuals and businesses to purchase their insurance. you have access to, within five years, must have an essential benefits package. minimum coverage. that and be the essential

benefits package. you have the basic plan, enhanced, premium, and a premium plus plan. the basic, low premiums and high deductible just like we see now. premium plus, higher premium, lower deductible. what is the health care reform bill do to protect consumers? we spent four years working on this. it prohibits insurance companies from discriminating against preexisting conditions. you prohibit insurance companies from rescinding policies except in the case of fraud. -- per your application to kick you off. the only way they can do it is intentional fraud.

we take away the lifetime caps on benefits. most policies are limited to about $500,000. you think that is planning. after a serious accident or illness, it is not. you limit the out of pocket expenses. in the house bill is $4,000.8000 dollars. -- $4,000 and $8,000. all these prisons take effect immediately. if the house and senate come to an agreement and they pass the bill tomorrow, all of these provisions start immediately. plus two more provisions. immediate help for the uninsured. in the house bill, provisions do not start until january 2013. we have a temporary insurance program for those who are

uninsured you have been sick or do not have a policy. we are here at michigan tech. if you have a policy with a son or daughter going to college, they are on your policy until 22. we say we leave them on until they're 27 over the day. -- until they're 27 birthday. bringing new doctors into the health-care system, you are a new professional and restart that before 2013. again, that is only if the bill passes. the house is a public option and the senate does not. it is a government sponsored nonprofit health-care plan. what does that do? it is basically medicare. how do you pay for medicare? everyone of us under 65, there

is a payroll deduction for fica. if you are 65, parts d medicare is a monthly premium. when we do the public option, how you pay? payroll taxes in your monthly premium which is similar to medicare. it is not funded by the government. whether it exists is a whether or not people participate. it has to be self funded, have the same financial is solvent and environment, and will only exist as long as americans want it. if you do not wanted, do not use it. no one will force you. benefits for the first district, 50,000 uninsured in this congressional district at about 660,000. 17 dozen 900 small-business is will be eligible for tax credits. -- 17,900 small businesses.

it has a prescription drug benefit plan. i thought it was a giveaway to the pharmaceutical industries. basically, they pay their premium and once you hit $2,500 you fall into the doughnut hole. you're still paying the premium, but when to hit $2,500 it all comes out of your pocket. what to him about $5,800 you come out of the doughnut hole and get picked up again. most seniors to hit the doughnut hole go back in about november or december. you have three-four months where you have no coverage, no benefits and are still paying a premium. it was done to keep the costs of premiums affordable so they drop to that of the system for a while even though you continued

to pay for your premiums. we're going to close the doughnut hole. we have almost 12,000 seniors in that situation in my district. 1100 families to avoid bankruptcy. ask any medical doctor and they get in uncompensated care? it is $185 million in uncompensated care that we lose every year. myth versus fact. i think i can debunk most of them. there is no death panel. even aarp says the crew of distortion, this nonsense, there is no death panel. illegal immigrants will not be covered. this is the exact language. no federal payments for undocumented aliens.

here is the section. section 1786 of its medicaid and children's health program for illegal immigrants. the manager's amendment includes for the protections and the verification of citizenship or those lawfully here in this country. there are three ways we address it in the bill. ever and says, you're going to force me into a government sponsored health-care plan. it is your choice to decide what you want. if there's one thing and the with you, health public republic health insurance -- public health insurance, you choose. i will not choose for you. no federal employee chooses it for you. you choose what is best for you. choose between private and public option. it will be another option yes.

if you do not want a government sponsored -- according to the senate is 60%. i could sum up it is about 40% to 44%. department of defense, indian health care, at children's health initiative, these are all government sponsored health care, the va, tricare. that's what it is. it is not a big, mysterious plan that is going to swallow us all a whole. how are members of congress affected? one senator said we should not be a part of this plan. we are treated just like everyone else. we are not offered a separate cadillac plan. if you work for a fourth service, you have the same opportunity as a federal employee that i do as a member of congress. -- if you work for the forest

servers. there's no special plan. there are 4600 federal workers in northern michigan that have the same options i do. will i go to jail if i do not have health insurance? no. everyone has to have health insurance whether it is through your employer are going through the exchange. if you do not take insurance, we're going to take a 2.5% of your paycheck to health -- to help pay for health care. the system is still there regardless. even if your 23-years old but you expected to be there when you get in an accident, we expect to doctors to be there, you have to pay. because it is tied into the irs and payroll, in rare circumstances when you from the irs you could get jail time.

no one will go to jail for not having health insurance. you long coated jail if you do not have health insurance. you're going to be to 5% but you will not go to jail. -- you are going to pay 2.5%. we're not going to take money from the federal treasury, your tax dollars to create an insurance companies or put money into insurance. this is just like medicare. payroll taxes and a monthly premium. in the house bill, we have a surcharge called the millionaire tax. tutored 70 household -- 270,000 for the family makes more than $1 million there is a surcharge. 99.91% sine will not have to

worry about that here in this district. waste, fraud, abuse, long-term savings, and changing how we pay for health care. let me explain this and how you come up with about all this money in 10 years. what happens to medicare? you're going to cut medicare? in november, we will not. you still go near same doctor, your hospital we eliminate the copays and deductibles for preventive care. --no, we will not. bone density, mammograms, went pay for these and we want you to get them. -- we want to pay for these. if you have prostate cancer, there is a 95% chance of curing it when we catch it early. taxpayers save money in the long run. bop's by the member that does

not hold? whether it is the house version, $500 into the doughnut hole starts at 3000 and refilled in by 2016. the largest consumer purchaser of drugs in the country is the federal government for medicare and medicaid, department of defense, and the va. your purchasing power to get a better deal on drugs, we cannot use it. it was a crazy provision. we changed it. the few years that, you can probably lower the cost. here's what i mean about changing the inefficiencies out of medicare.

in early spring, a group of us came together. we said that the traditional way we pay for health care is every time you get a test, there is a bill, every time we see a doctor, there is a bill. built into those bills are all kinds of administrative costs. what we found in our work on the committee that if you are in miami, fla., the average payment for the medicare reimbursement in miami florida -- in miami, florida is $16 and dollars. is health care that much better in miami and that it is worth $16,000 versus the $1,600 here in marquette? you get better, you get treated, there is the quality outcome not how many doctors you see, how

many tests that are run. we want to move away from quantity and go to quality. does it make a difference how many times to poke me if i'm treated for diabetes? the end result is, and live better? it is equality based outcome. it will take us three years to do this. reimbursement will be based on quality not quantity. here's a quick nap. total medicare reimbursement. medicare payments in 1965. here is a graphic between the differences. the upper midwest, minn., the light green were the lowest costs. the orange and yellow were the highest costs. these mistakes that got us the most in trying to change the system. this is a drastic change for the way we reimburse health care in this country. here is the graph. here's what you average. if you are on medicare, what is

paid out per year on average a nationwide is the green line. $8,300. the lowest is honolulu, hawaii. the highest is miami, florida with $16 and dollars treated 51 -- $16,351. [no audio] >> sorry about that. my district alone, the first congressional district, in

marquette, $6,100. here's the national average. in saginaw, they get reimbursed almost $8,600. detroit is $10,000. why the difference? is health care getting better in saginaw verses marquette? i do not think so. these are inefficiencies built into the system over 40 years that we need to address. ress the quality not the quantity. house of businesses be impacted? if you have less than 25 employees, how do you figure what you have to pay if your number of employees and the

average wage of the employers. it allows you to pay back through the exchange from health private or public. it depends on the number of your employees. i'm not talking about -- i'm talking but the payroll tax. i cannot afford health insurance. if my payroll is a $585,000 and i'm not writing my employees with health insurance, i would have to pay for% payroll tax -- 4% tax. 2, 4, 6, 8. the payroll is more than seven in the $50,000 per year, the most would pay is 8%.

-- if my payroll is more than $750,000. proceeds from the tax code to offset the affordability credit. most businesses that choose to offer insurance will see tax credits to offset the cost of insurance. veterans say they like their system and do not want a change. i want to keep my try care. -- tricare. try care stays the same. if i am a veteran and one to go into another plan, i can do so. you are not forced. ok the abortion amendment. i'm going to explain this. i have always been pro-life. we have been able to work out issues. there was no room to maneuver and no one was really willing to negotiate past a certain

point. here is what happened. july 30th-31st, i warned my colleagues do not even bring abortion up. let's do health care. let's focus on health care. leave abortion alone. it is it is -- it is a decisive issue. keep the current policy. there was an amendment offered that said this. the capps amendment -- is a recognized benefit under the health-care bill. it is in the public option, you have to pay $1 per month into a fund for reproductive i -- reproductive rights that included abortion language.

at least one plan must have abortion coverage. you can use your federal subsidies, tax credits, what ever, to pay for abortions. that is completely against current law. current language as we do not use public funding to pay for abortion or for insurance policies that provide abortions. that is the current law. capps passed by one or two votes. i polled my amendment out of the pocket which says, go back to the original law, no public funding for the abortion, no federal subsidies for abortion in the health-care bill. it passed 31-27. german waxman switched his vote. -- chairman waxman. they got all the democrats there and we had a real vote. we lost 30-29.

that is how the issue got into health care. we did not wish to make it an issue. that is what happened. we had the bill with the abortion language i objected to and many members of the house objected to. we wanted the speaker to give us an up or down vote. if they did not give this a vote in the health-care bill we would not support the bill coming to the floor. i have had a rule to bring a bill to the floor with 218 votes. my mother-in-law died and i flew back on november 6th to. -- 6th. i went to the pro-choice caucus and explained the agreement. everyone shook hands and we all agreed. the speaker called me and said the deal is off. perchers caucus says we will

this -- we will be the amendment. i testified at rules committee at 1:00 a.m. the next morning, saturday morning, my amendment was in order. it went to the house floor. perron was calling press conferences. we passed 240-194. it was bipartisan. 64 democrats voted for it. all 64 also voted for the health-care bill. the only built it -- the only reason the bill passed was because my amendment. the public health care option would not be allowed to cover abortion and the federal affordability credit does not cover that. it does not take away your right to choose. it only says that the government is not going to pay for abortions but we have not paid for them in the last 33 years. the usual perceptions for rape,

incest stand. women in business as if you want to buy a separate plan, severed covered you just cannot use the tax credit and federal subsidies. christmas eve, the senate bill passes. the next step is the conference committee. as you have been hearing, it will probably be pingpong. they'll bring back to the house floor. when it comes back for a vote, you're not allowed to change it, amendment, or alter it. you get one vote, yes or no. they say they are trying to for the end of january. we will see. most of the members i have talked to, about 20 members since the christmassy vote, -- the christmas eve vote, some pro-choice and some pro-life,

they said they will not vote for the senate bill matter what it is. senator reid keeps saying that is the best he can do. here's the difference between -- here are the differences. this is why we have such strong feelings. when you difference from when they take effect. we pull the don't hole in the senate does not. we have a public option and they do not. they create two plans greeted by the opm. we take away the antitrust exemption. if they want to raise their rates like they have on individual policies in michigan 20%-40%, there's nothing we can do about it.

they can do what they want. it is limited regulation on the insurance industry. it will allow to create competition when they take the antitrust law away. we have the when million dollar surcharge. if you are an individual, they put a surtax on you. if you are a family and you are $23,000 or more, you get taxed. deficit, we will not add to the deficit. cbo says 138-132. it will not be government run. 6 million more people will be covered. regional differences, remember the difference between $16,000

in miami and $6,100 in marquette? the senate leaves the system the way it is. if it is a broken system, why do we keep it? house we change it. senate keeps it. the federal funds for abortion. the senate has basically the capps amendment repaving $1 per month in you can use federal subsidies to pay for it. option in a nutshell, those of the differences. i know it sounds like a long presentation. -- that is health care in a nutshell and those are the differences. this is the one that affects everyone of us now and in the future. i thought it was worthwhile to do this presentation and take the time to get this through. we have about an hour for questions and will start with

questions. again, we have a large crowd. i will try to repeat your question so everyone can hear it. ask a question and we will move on. be respectful of everyone. yes, ma'am? the question is how can we use our influence to get them to include a public option? i am not sure because the senate has already voted against it. i think what we have to do and what i am hoping for, because i really want to see health care passed, i am hoping for when we go to the conference that they come up with an agreement, may be a trigger, but the way the senate doesn't there is nothing. it said, ok, you can only pay so much out of pocket, a percentage. if you want to make more money,

just raise the rates in your percentage stays the same? it really does not do anything. hopefully they work it out in conference. there are a lot of other problems with the senate bill. we felt that this was a national policy. this legislation should stand on its merits on policy and not for a special deal. public where nebraska or have to pay the estate share of medicaid. i believe that is unconstitutional. i am louisiana, so do i get $300 million upfront? all the other states lose medicare vantage within five years, but florida is to keep it? why? these have to be dropped.

with all respect to senator reid who says he cannot pass health care without these deals, then he is going nowhere. house members are disappointed, like the american people. there are two things to watch. legislation being made and sausage. -- there are two things you do not want to watch. this should stand on its merit. michigan was one of the first it's economically. -- one of worst states economically. let's pass this on policy. i always thought they would do a trigger. no greater than the rate of inflation, if it goes, trigger a public option. that is one when they talk about a compromise. that makes sense. this the one this side of the room. -- let's go to this side of the

room. [inaudible] but it could all be for naught. congress starts january 2011 and said they disagree with health care. they could get rid of it. every congress has a right to review it. congress has been talking about this since teddy roosevelt first proposed a 100 years ago. for us to get this far is a historic. look. i believe that the end of the day of all of the deals here and there, this issue, even the abortion language, there's a strong sentiment in the u.s. congress that it might not be

the end of january or february, i think it is going to get worked out. there's a will to get this worked out finally. maybe senator reid had to do this to get his 60 votes to get a village a conference. i am hoping they get it worked out. i'm waiting for the president to provide a lot of leadership for this to say this is a bill he either can't or cannot sign. work it out. -- he either can or cannot sign. i recall asking me how we're going to work out the abortion issues. there are reaching out and trying to get issues resolved. i hope it does. if it does not, as i said, if you bring it up at the end of january, maybe you do have to

look at this. does -- it does not provide you for bringing it back three days later. i've seen this many times. there is time to do this. everyone wants these artificial deadlines. maybe it is good because you make members to make a decision. it had been the fascinating for ever on health care in this country. eventually you have to make a decision. we need a health care bill eventually. [inaudible] the question is whether they will -- there will actually be a conference committee, a full blown one. i do not think so. it will be the chairman waxman, the author of the bill, ways and

means, labor chairman, the ranking republican, and the senate will put their people up. they will meet a couple of times. the hard-core discussions will go on between status and members on and off the floor region staffs and members -- will go on between staffs and members. will there be a conference of where you can see this and that? no. they will craft a bill together and say here is what we will -- we think will appease the most caucuses. i do not think there will be a true conference as we might envision it. yes, sir? nope. the question is, is it true that congress will have a different

plan? no. same plan as any other federal worker. no, same. public option. all plants have to have the essential package. -- all plans. every plan has to have the essential package with four levels. basic, enhanced, premium, and premium plus. you pick what you want and that is the same thing federal employees do now. when my sons were growing up, we were on the plans with all of the bells and whistles with young children. now we want a different plan. if i'm single, i might want a different plan. it will be the same. we'll basically have the same choices. yes, ma'am? [inaudible]

the question is -- i think it wascigna. we have done if you press conferences together. it -- i think it was cigna. he has shown us some of the ins and outs of the insurance industry and how they have the 1400 different programs that drew your reviews of your policy. if they thought you were going to put in an expensive claims than they would kicky. they have been very helpful in in some investigations i have done. he is a source of information i have used in the past. yes, sir? [inaudible]

we're all concerned about spending, federal spending, stimulus. i asked myself within the last five years, where was ever a concern of about the spending five years ago? our debt was about $5 trillion when president bush left office it was $10 trillion. we have added since then. we double that in five years and it did not hear anything. . .

we passed the deficit reduction package. no republicans voted for it. by the end of president clinton's term, we had surpluses. get the economy moving and go back to things like pay as you go. you got to pay for a program. that is why in this legislation the president said we would not increase and that is why we pay for this health care plan through the house care bill. we cannot say print more money and provide health care. everything you look at, what

is the deficit? what percentage is it? as our economy grows, in relative terms of the economy, it may not be that great. will it take some time? sure. i think we can get it back under control. pay-as-you-go. yes, sir? [inaudible] here's what we did on the house bill. the question was toward reform. ontort reform was one way of doing it. he ordered the secretary of

health and human services in discussion with leaders, what are states doing to curb costs? you have access to the court. claims for tort reform and malpractice. take michigan. michigan 1994, we have the toughest for reform laws in the nation. there were caps on damages and who could sue in to have to have a certification, all kinds of restrictions. we're the only state that said you cannot sue the drug manufacturer for harm. here where in 2009. we have one of the highest malpractice rates in the nation. we have the toughest law. there is more to it than passing caps or limiting your damages. illinois, a big city. we have detroit. chicago has never had toward

reform. they have some of the lowest rates in the nation. they are like us. they are a big city. where are their differences? the state of texas past one and that seems to be working well. what they have said, look at these. we do not start till 2013. what works and how can we do it? what do we know who they are? those are suggestions. i should have a slide on it. it is estimated it might be as much as $100 million. remember i said quality as opposed to quantity? quality based outcome. that will put standards and treatment, standards of care. that will help us establish what

is malpractice and what is not. >> [inaudible] doctors will say that will affect my reinbursement. >> sure. or do some of the toughest cases go? the mayo clinic. -- where do some of the toughest cases go? it is based on quality based outcome. excuse me. i worked with them. there is a dartmouth study. the article you read on the mayo clinic about net taking patients

is a clinic in arizona. -- not taking patients as a clinic in arizona. read the article closely. if you want the names of the people at the mayo clinic who testified before congress, i am going to this -- they were one of the big advocates along with many other upper midwest providers. i would be happy to provide it. we have worked with them very closely. this change going from quantity to quality with tough negotiations. the east coast and california have teaching hospitals. they have special reimbursement because they are teaching hospitals. that is great but the teaching hospitals cost us a lot of money in the system because they have the designation of teaching. we have to fight off massachusetts and miami and san francisco. we got it done.

this is the best way to change the system. let's go away in the back. >> you mentioned [inaudible] and at the same time you said that [inaudible] >> the current law is to abortion. >> [inaudible] was this based on religious doctrine or is the impact [inaudible] >> none of the above. the federal government does not pay for public abortion. if we are expanding the role on health care, those prohibitions should continue.

>> [inaudible] >> yes. >> [inaudible] >> we are changing the system from quantity to a poliquality based system. to get equality to the -- get quality to the american people. there are four levels. you can buy anything at those four as long as you get a subsidy. that has been a lot for 33 years. >> [inaudible] >> no. no. no. 40 to 44% are the ones not on

government sponsored insurance. they have a policy. the federal government, those policies do not offer abortion coverage. the same insurance companies offer federal employees and some take a writer for abortion coverage. they are allowed to do that. >> a woman who might be [inaudible] and not covered [inaudible] she would have to pay for additional coverage. >> correct. pa18% of abortions are covered

under health insurance. 82% are cash payments. it is a policy we never had. the only vote on the issue, 55% of the elected representatives said there would not be of benefit. they wanted to to put oral health care in the basic plan. that is a good benefit. the cost factor is not part of the plan. for children they will be covered but not adults. we are in the position where we have to choose what benefits we are going to fund and not fund under health care. this is one that we have chosen. after the amendment, two polls were run and 61% said we do not

want funding for abortion. the march toward the americans do not want public funding for abortion. -- the majority of americans do not want public funding for abortion. let's go to the side. >> [inaudible] >> ok. >> i continue to work with leadership and hopefully we can get this issue worked out. [applause] >> let me put it like this.

there are 10 to 12 members. let me finish. >> [inaudible] >> let me finish. we have been negotiating with leadership on this issue. i told you monday night. i expect when i go back monday we will talk some more. i hope to get it worked out. if this public funding for abortion, if we change current policy, i will read the bill, make sure if that is the last issue, i probably will not vote for. but i am not going to -- we're still negotiating. you do not play all your cards at the table when you are negotiating. this is an issue that we have the only clean vote on and the majority of american people do not want it.

i would be hard-pressed to vote for something that has public funding for abortion. everyone always says no tax increase. i do not do this. let's read the legislation and see what it says. my record is clear on right-to- life issues. i am solid on that issue. >> i don't agree with the way the bill is structured. mandating people to have health insurance. there are no exceptions for va. [inaudible] why don't you take that money and reinvest it in medicare to

make it more solvent for the future. [inaudible] we can't go to a doctor to find out how much a routine visit will cost. there are routine procedures we should be able to compare and contrast. what we do something along those lines, making it more visible -- why don't we do something along those lines, making moit more visible? >> the question is why do we do a simpler approach and why do we have transparency? there is transparency and it does apply to the hospitals in the house bill. i appreciate the sound effects but let me finish. wait. ok? all right. transparency is in there.

i do not have a slide in it -- on it. if you want -- if you are concerned i am happy to send it to you. when i am trying to answer the gentleman's question, please keep your comments to yourself. we tried to do it on pharmaceuticals. that is the one that will save as the most money. we tried to get it, we could not get it through. it can do some shopping to see what is best. the simplest way to do this, i said this is the way to do it. those who do not have insurance, let's expand medicare and let people buy into it. why don't we start at 55 and let people buy in sooner? for the people who do not want either program, why not allow the federal employees health

benefit package to be available and let them pay the premium. federal employees are all over the place. why don't we do that? that was not accepted. this is the bill that came out. i stinstill think overall we are competitive. we need health care to cover all americans for the last -- we are the last industrialized nation to do it and it is time we do it to make us more cost competitive and give you -- 62% of bankruptcies are for medical expenses. 70% of those people have health insurance. you pay for the uninsured. in your taxes for medicaid and medicare. we're paying for it directly and indirectly. >> that does not address the cost of health care.

[inaudible] >> take away the antitrust exemption. why should they be the only industry not subject to antitrust laws? that is what the exchange is going to do. every insurance policy is up there. hospitals will have to do it but i think that transparency has to expand to drugs. the doctors [inaudible] should be there. the more power you have the smarter decision you'll make. >> thank you. >> i would like to think the federal government for keeping my brother alive -- thank the federal government for keeping my brother alive. no insurance company would cover him. he is a lot thealive today.

you were mentioned on rush limbaugh on being more outspoken on health-care reform than any republican in congress. i you willing to sacrifice progress on reforming our system, by your numbers, 45,000 americans who died due to inadequate coverage. based on your position on one issue? if you do, does that demonstrate a bit of hypocrisy? >> the issue is will i give up that to abortion position and right-to-life if these other 45,000 americans die every year? does that seem like a conflict? it does. why are we changing the law in this area that is controversial? the amendment went through on november 7.

on december 16, just about every member of congress voted for right-to-life language, basically the stupak amendment. all this stuff, we can do this and we cannot vote for it. they voted for it twice. and also, december 16 in the appropriations bill. there is what my language was taken from. what i am saying to the president and the rest of them, they are saying you cannot do this. even though the american people say we do not want you to have public funding for abortion. you just signed a bill that had language in there. where are you making this the hurdle if you are concerned about those 45,000 americans without health care? we're at the table.

we will see how this works out. i think we can work this out. we had an agreement on this abortion language. everyone else signed off on it. they insisted on a boat. they had their rote. -- vote. now they want to take it away. i thought in a democracy, majority rules. we in the back. >-- way in the back. >> [inaudible] [inaudible]

>> no. teaching hospitals. brett example, los angeles. ongreat example, los angeles. usc gets $60,000 in reimbursement. ucla which takes everybody, [inaudible] the other one, they take every one and they get reimbursed. what is the quality of care in l.a.? which hospital is going to accept you. we have to get rid of cherry picking. on illegal immigrants. if you go to the emergency room,

you are entitled to care. in this bill, it does not see before you get care, show me your passport. what it says is, we have to verify it. you come in and get treated and that we will ask for credentials. win the -- is the emergency room going to be used by people who may not be in this country legally? yes. do they have to put forth rules and regulations? yes. can we cut down on that? yes. is there amnesty for people illegally in this country? no. there is still parts of it. we are trying to address those concerns. this side.

>> you said a couple times [inaudible] how come polls show that [inaudible] [applause] >> it does rule. the question is, on the abortion issue. the majority of people have expressed their views and the polling indicates the majority do not want it. therefore, majority rules. the question as if the majority of people do not what this health care bill, why don't we just vote it down? all the information our office has, we have been receiving your

faxes and the males. it is 50-50 for it and against it. when you look at the polls, heritage foundation is 85% against. if you look at others it is 50 or 60. how you frame the question determines a lot of it. when you say, should it be a public option? it is 40% in favor. should you allow insurance policies to go across state lines and take away the antitrust exemption, it is 70%. what i do before a vote on legislation is rated. i do my vote accordingly. are we driven by polls? no. when i say majority rules, it has been clear that there have been three polls on the issue,

showing should there be public funding? 64 democrats voted with me. 24 were pro-choice democrats but they feel when it comes to public funding for abortion that is a line that will not cross. they will not restrict your rights but did not ask us to pay for. they do not fill comfortable asking the taxpayer to pay for. it is a different issue in health care. we do not rule by polling. >> [unintelligible] >> right. >> [inaudible] my question, you listed teh

he different plans but you do not list the price for those. >> the basic plan and what has gone into it is said by the commission which has not even met yet. they have to pass legislation. certain things like i said, children for under 19, dental care -- no one considers that a basic thing. mental health is not in there. chiropractic, maybe in the enhanced plan. the estimate is it is $10,000 or $11,000 a year. >> [inaudible] >> great. >> [inaudible] >> wait. >> [inaudible]

[applause] >> ok. under this plan, if you have a plan, keep it. you are not affected. and you go on line and pick the plan you want. all right? we're not going to pick it for you. if you say i do not want any, you will pay 2.5% payroll tax. we're not going to determine if it for you and make those determinations for you. this is a basic plan that has to be out there. and put it forward. >> [inaudible] >> you are being taxed right now for medicare. i have been told [inaudible] >> i hope you don't bank with

social security. social security was meant to be a supplement. if you are saying social security will take care of me, that is not what it is designed for. no one has lost their money in social security. yet. you're right. both of them because of your work are being paid into. we have more money going in than going out. there comes a time about 2018 or 2021 on health care where expenses will be greater than what is going in. right. what do you do? the easiest solution we should do as a country on social security and medicare is make

all income subject to this social security and medicare tax. it is capped at $94,000. if you make more than $94,000, why should be capped? when they set up in the 1930's, it would -- it was because you should be guaranteed an amount and if you make $1 million, you'll never get back that much in benefits and that was a reason. the administrators of social security said decants of 99.9% of the problem if you make in come, all income your income. not capet at 94,000. every year it goes up a little bit. -- not cap it at $94,000. if you are entering the workforce you do not get full benefits at 65. it is 67. it is 66 for me. that is different from my

parents and younger brother paid for. there is changes going on in there to make it more solvent. i will take one more question. i will be here for a little while longer. way in the back. >> one of the things [inaudible] so if you level the playing field, how do you [inaudible] has the motivation under the government plan, [inaudible]

>> sure. the question if i can summarize, if i am a doctor have gone to school for years and i come out and i am looking to set my practice and i get reimbursed so much. but then payments will be leveled from 16,000 in miami to 6100. what incentive is there for the doctor to put in extra time if government levels the playing field and he does not see any reward for his investment and effort in investment? is that fair to say? and being a good doctor. or onthe dcotor [unintelligible] in the first district is $185

million. doctors and hospitals are saying we have so much uncompensated care, even for the person we see and the payment may be lower. if we have the payment that is better than what we have right now. there are administrative costs. hopefully it is going to go down. they spent a lot of time and effort and expenses and trying to collect from insurance industries and things like that. administrative costs alone in health care is probably somewhere at least 30%. it is at least 30%. healthcare is a $2 trillion dollar industry. it is 7:00 and i will be here for a while. i will be here to answer your

questions. thanks for coming out and thanks for having me here. [applause] >> tomorrow, david lightman and drew armstrong join us for an update on congress. after that, former republican party chairman ed gillespie. later, juan williams talks about race, politics, and the days. -- the news. later, senate republican leader mitch mcconnell talk to reporters about afghanistan, u.s. foreign policy, and the senate's agenda. that is live at 10:00 a.m. eastern. >> the veterans affairs

department said that suicide rates have risen among male veterans or 18 to 29 years -- who are 18 to 29 years old. after that, the debate for an open u.s. senate seat in massachusetts. later, senate majority harry reid on this 2008 " on president barack obama's skin color and electability -- on his 2008 quote on president barack obama's skin color and electability. >> now available, c-span's book. a great read for any history buff. from his early years to his life in the white house and his relevance today. in hardcover at your favorite

bookseller and now in digital audio to listen to any time. available where digital audio let downloads are sold. -- a digital audio downloads are sold. >> speakers include eric s hinseke. this is an hour and 15 minutes. >> how exciting. we have about 1000 folks who have signed up for this conference so we're excited to have you here. this is our second annual dod va suicide prevention conference. we have been putting together quite the agenda. we have over 100 presenters up through thursday so we're excited. some of the most well-known experts in the field of suicide. we have quite the agenda.

i am the chair of suicide prevention and risk reduction committee. i'm a public health service officer. what i would like to do is take a few minutes to go over some administrative announcements. during all flanary and brigance sessions, -- plenary and breakout sessions, please silencer cell phone. please be mindful of the time so weekends day on schedule. we want to make sure -- we stay on schedule. please be sure to sign up at the registration desk. each session you will be

evaluated individually. they will be a evaluatevaluated individually. per accreditation policy, ees requires 100% attendance. a certificate will be mailed to you after you submit the information. please review the blue sheet of paper in your folder. i would like to introduce you to my co-chair of this conference, dr. janet kemp. [applause] if you have concerns or questions or ideas belplease

feel free to find either one of us. we would like to have you look at your agenda. it has the quiet room we put on the agenda. wyou are able to use the quiet room every day. if you find the topics are difficult, we wanted to make sure you had someplace to go just for a short break if you are needing to do that. what i would like to do is introduce you to thebrigadier- general sudden. -- sutton. [applause] >> thank you for the work you

have done to bring this together. we have a number of leaders and distinguished guests who will be joining us, some of whom are already here. i would like to give a special welcome to ellen embry, performing the duties of the acting assistant secretary of defense for health affairs, secretaries and jackie -- secretary shinseki will be here and the deputy commander for reserve affairs for the green car. we have rather admiral daniel holloway -- rear admiral daniel holloway.

we're pleased to welcome the deputy commander for the joint task force of capital medicine. the joint stop surgeon -- we have brigadier-general byron hepburn. we are pleased to have bonnie carroll, the director of the tragedy assistance program. please join me in welcoming our distinguished guests. [applause] i cannot tell you what it is to look across this audience. of all the things that are demanding our attention, that each of you would make this a

priority. it speaks volumes. this is not business as usual. we're here over the next few days to learn, to share, to grow, to connect. as i look across this room icy colleagues and friends from the be a -- i see colleagues and friends from the va. i see nco's. i see retirees. i see family members who have survived the tragedy of suicide and who are our experts from whom we must learn and for how we must continue to support. please join me in thanking the family survivors who are here to teach us this week. [applause]

a wise person once said, be kinder than necessary. for every one we meet is fighting some sort of battle. i know i am. i know you are. those are not limited to the war zone. they take place on the home front. they involve the struggles with injuries that are moral, physical, psychological, spiritual. seen and unseen. and they also lead to the potential for us to claim strength, no matter how adverse our experience has been. over the next few days, we have

the opportunity to learn new and better ways of strengthening individuals and communities to build resilience. to maximize recoveries. and to foster reintegration at all levels. preventing suicide involves much more than recognizing and acting on the terminal signs of hopelessness and despair. as important of course as those awareness and actions are. it involves for each one of us to build and develop and grow a tool kit, a tool kit for life. one that involves tools for sleep. the number one issue affecting

our troops coming back and forth from the battle zone. it involves the tool of fuel. are we putting the kind of fuel into our bodies that helps our brains, our bodies, our spirits perform at maximum effectiveness and efficiency? do each of us here have at least two individuals that if we were to reach that hour of darkness, that moment of truth, that we could call a friend? and gain that human-to-human connection?

do we belong to a team? do we fit in? those relationships are what healing is all about, what love is all about, what life is all about. got love? do we have people in our lives, pets, causes, endeavouavors, that we put ahead of our own? do we have health? it is more than the absence of disease but involves the presence of energy, optimism, compassion, grace, gratitude, grit, and strength. do we have faith? faith that leads us to a

commitment that is greater to us as individuals. hope. any of us who is without hope is most at risk. growth. that potential for claming postiming growth. if everyone of our front-line leaders, those nco's, those troops, if they knew the answer is about each of their troops, if we knew the answers about our family members and leaders and ourselves and how to engage each other in a meaningful and productive dialogue, perhaps we would be a step further away

from the terminal signs of hopelessness and despair. that is our challenge. this is not business as usual. for as much as we have to learn, as much as we already know, we know that preventing suicide is first and foremost a public health and challenge. -- a public health challenge. at the center of our attention, the health and well-being of our warriors, our veterans, and yes, our families, those who are courageous enough to love us, but it goes on from there. we must build peer to peer support networks. we must build brazilian families and communities. safe leaders. -- we must build families and communities. elected officials. and yes, health care

professionals. let me be clear. preventing suicide is far too important and too enormous of a challenge to be left to the doctors who ars. we are in this together. we know that psychological, spiritual, and moral injuries are on a par with physical injuries. the chairman of the joint chiefs of staff says that frequently. we are blessed with the strength of visionary leadership at all levels and in both departments. we know that these invisible wounds of war, whether depression, posttraumatic stress, anxiety, concussion, traumatic brain injury, we know that these invisible wounds are real.

we know that you are not alone. we are all in this together. we know that treatment works. treatment based on an integrated team health model of care that covers the entire continuum from the point of injury or exposure or distress, all the way through from the battlefield, to the home front, to the bedside, to the kitchen table. we also know not only does treatment work, but the earlier we can intervene, the better. we know that reaching out is an act of courage and strength. as hemingway once put it, the world breaks everyone. and many grow stronger at the

broken places. finally, we must double down on our commitment to eliminate not just to minimize, not just to reduce, but to eliminate stigma. that toxic, deadly hazard that all too often leads to needless suffering and loss. in summary, we are on a journey. treatment can save and help is hope. perhaps summoning the wisdom of churchill, we're not at the

beginning. this is not the beginning of the end. this is the end of the beginning. a time when we can look back and learn. we can tool up and go home and apply these lessons and ask ourselves the question, is what i and my team are doing today, is this action? is our effort, is a worthy of the service and sacrifice of those -- is it worthy of the service and sacrifice of those we serve? not content with today's best, we must make today's best better every single tomorrow and the day after and the day after. to this and, i am deeply honored -- to this end, i am

deeply honored to introduce our guest speaker. a fellow traveller on this journey. a 34-year veteran of the department of defense. someone who has pioneered our understanding and efforts in support of health protection and readiness. someone who more recently i have had the opportunity and privilege of serving with these last couple of years in the domain of the invisible ones of war, psychological health, traumatic brain injury. now performing of the duties of the secretary of defense, ellen embry comes to us as an esteemed colleague. to so many of us in this room

and around the world she is a role model, she is a mentor, a teacher, a coach, and a dear friend. please join me in welcoming ms. ellen embry. [applause] >> good morning, everyone. i am here on behalf of the secretary of defense. mr. gates unfortunately was not available today and so he asked me to come in and provide some opening remarks on behalf of the department and i am pleased to do so. thank you for those very kind words and that wonderful introduction. good morning to everyone.

welcome to this second annual dod/va conference on suicide prevention. it is the only conference established to specifically address the issue of suicide in the military and veterans' population. it is very important that you all are here. it is obvious you care and you spend many of your days and nights caring about this issue and making the difference in the lives of our service members and veterans and their families. i want to thank the distinguished guests who are here who were mentioned earlier and of course, i would like to thank the chairman of the joint chiefs of staff will be here later. he has been especially dedicated to this issue and has been quite an advocate for the department and helping us all to see and address as a matter of priority the unseen once a war.

i would also like to thank our conference call hosted a partner, secretary shinseki. so, let's talk a little bit about the tragedy of suicide. every life lost to suicide is both a personal tragedy and a tragedy to society. whether civilian or military, it is a tragedy because of a human life has been lost. it is also a tragedy because for all of our sophisticated knowledge, we still do not know all there is to know about preventing these needless deaths from occurring. at a media roundtable last november, the army's vice chief of staff briefed the press on his service's suicide prevention efforts. the challenge of suicides, he

said, is without a doubt the toughest i have had to tackle in 35 -- 37 + years in the army. simply stated, he said it is not a single problem with the defined set of symptoms or markers. there are no easy answers or solutions. and as we all know, he is right on all counts. suicide is a complex issue with any number of risk factors. it is hard to predict. while we are alarmed at the number of suicides increasing in the military, some 311 occurred in 2009, most not occur in the theater of operations. most are related to the same factors that precipitate civilian suicide. substance abuse, failed marriages, or relationships, and a legal or financial matters. according to a 2008 department of defense report, 64% of those

who died by suicide did not have a diagnosis psychiatric disorder. 49% received medical, of haverhill, and family services 30 days prior to their deaths. knowing this, what is it that we can do to reduce the risk and the number of suicides in the armed forces? -we should make sure that people understand there is a wide variety of resources to help them before they become suicidal. that means increased sensitivity to warning signs, comprehensive prevention and education services throughout their career and programs that target risk factors.

increased access to information and care, enhance community and peer support, and finally, and most importantly, quality research, surveillance, and analysis to close our gaps in understanding and to identify best practices for prevention. sigma is another key to prevention. we have taken steps to reduce the impact of seeking help. the real warriors, real battles, real strength campaign provides examples of members who have saw care for psychological health issues and yet still maintained a highly successful military careers. there are several web sites in self assessment programs that help to enable our service members and families is to seek

help confidentially and identify problems before they become serious. video and other educational materials are in widespread use helping families and children to cope with deployments. telephone hot lines, with licensed mental health consultants provide help. there are multiple transition programs available to help bridge the support of our service members who are between health care providers or systems, according not just support and encouragement, but also continued use of needed services. in short, that as far as the department of defence is concerned, there is no individual, family member, military leader, or va or dod or other community resource that could be omitted from the

suicide prevention equation. because suicide is a great concern for the department of defense, each of the individual military services have instituted significant efforts and programs to prevent suicide. for example, the air force has inc. suicide prevention into -- incorporated suicide prevention into their programs. they have trained over 1000 mental health staff at 45 installations. . .

the marines have implemented a program involving the two-hour suicide intervention training session. it includes a warning signs, engagement with fellow marines, and information on how to access of friday of local and national support resources. marine commanding officers also create personal prevention messages to help removes -- help reduce state month, and a suicide prevention message is incorporated into the marine mandatory martial arts training program to demonstrate the value of resilience and the importance

of seeking ways to identify and mitigate emotional stress. in addition, the marines had implemented a dedicated hotline to a nss those with relationship rock -- to aid and assist those with relationship problems. the navy has a group to highlight education including a comprehensive program to address psychological help needs of sailors and their families. they have conducted a personal readiness summit with reconcentration areas on a range of topics including suicide prevention and operational stress. in addition to a trained program -- a trainer program that was established at locations around the code, they have also assisted leaders in recognizing and responding to sailors in distress.

many of these examples are not inclusive, but they highlight a holistic and comprehensive strategy that we attempt to bring to bear to confront the challenge of suicide. we're doing is primarily for increasing information and awareness, bringing very -- bringing very strong levels of support at a 360 degree level and reducing statement to the extent possible to those who are trying and need to get help -- and reducing stigma to the extent possible to those who are trying and need to get help. this is not just our commitment, but our obligation to men and women who sacrificed so much to keep our country strong and free and able to do what we do on a daily basis. we owe them a debt of gratitude. we owe them the very best that we can give them. we are committed to reducing the burden of suicide.

the communities of partnership of both the department of defense and the department of veterans affairs are absolutely dedicated to this issue. our attention will not flag and our dedication will not falter. part of that dedication and commitment is conferences like this one. it is designed specifically to actively engage service members and their families in suicide prevention. and to provide the resources that we need and ultimately to improve those resources and the substance that drives their success. we want to reduce the number of suicides among our veterans and in the military, and hopefully what we learned will transcend it to the national risk suicide prevention as well. i want to thank you all for coming. i know that this conference is important and i hope that when

this is over, you will be able to take away significant things that you can do back in your job to improve what we do for our soldiers, sailors, airmen, marines, and coastguardsman. thank you. [applause] >> ladies and gentleman, please welcome back to the stage commander talkinhawking. >> the senior vice president for a foundation attained the rank of major in the years following his military career. on may 16, 2005, he was medically retired from the u.s. army from injuries sustained in

combat. on the 17th of august, 2004, he hit an ied, otherwise known as a roadside bomb. this happened while he was serving with the coalition of military assistance training teams under the command of then- commander david petreaus. due to the extensive injuries to his left knees, doctors had to employment -- amputate his left leg. his story of courage and sacrifice has been featured in "time magazine," fox news, cnn, and many national and other television stations and newspapers. senses amputations, he has been a staunch advocate for veterans with disabilities, specifically focusing on advocacy for prosthetic technologies you're visiting with fellow amputees at walter reed medical center

-- prosthetic technologies, peer visiting with fellow amputees at walter reed medical center. he experienced much of what other 6 pairs. he entered darkness and depression, pst, and also suicide ideation. this wound crippled his spirits. he called it the deep wounding of the soldiers spirit. during this time, he understood that as a warner -- as a warrior he could not walk alone in his journey. in that moment, he helped -- he asked for help from his spiritual adviser, his chaplain, his family, his therapist, and the american people.

this intervention helped pull his life back on the road to recovery. it also became his building block for understanding the inner wounds of war and for ensuring that metal called -- mental health advocates understand their responsibility to leave no one behind on the field of battle. [applause] >> thank you all very much. when i hear that introduction, i have got to tell you that i get emotional. one of the reasons is because when i got one of my blood transfusions, i think i got a little female blood. and now i cry all the time. [laughter]

just to hear that is incredible to me. first of all, on behalf of all of those that have served our nation, i want to take this time to thank you, those individuals that are here today, and those individuals that are back home all over this great nation, and tell you thank you for the support that you have given me in my road to recovery. i know sometimes you may not hear that. you are going to hear it from me. one of the things that is so important that as i faced those dark days at brooke army medical center, on october 1, 2004, when my leg was taken away, how sad it was that i sat in that hospital bed, not knowing what was happening to me, mentally, learning how to deal with the physical challenges and what was going on, and no wings that i

needed you -- and knowing that i needed you in my recovery. i thought about the fact that -- most people say, if it -- if anybody can get through this, is major ed pulido. but those hidden wounds were the ones that would cripple me during a period of time that i just not did not -- that i did not understand. the key moment that i want to tell you that was so inspiring to me when i sat there in that dark place, was the fact that i needed you to support me. you see, as i said at brooke army medical center, i did not know how i was coined to provide for my family, and that for me was the hardest thing that i

struggled with during this journey. when they took my leg, they took so much away, but i also knew that with the help of those service members who had gone before, and those individuals that had made our country what it is today and their service to this nation, that they would get me through those dark days and dark hours and make me who i am today. and for that, i think all of you for what you're doing. suicide for me is something that i faced and i had to talk about it, and it was there -- and it was my therapist, george, and my chaplain that were the instrumental figures in giving me my life back. so as i begin my presentation, i want to narrate my story to you and tell you that this is one of many stores, but i want to show you how important your support is in making our lives to a

successful as we come back from war and we become civilians and we learned that our lives have changed, but in the way they have changed for the better. i would have to begin by talking about what has made this country what it is today. for me, it is about winning. it is about having the service members being a part of a courageous group of people, and honoring our veterans and our service members every time we get an opportunity. they're the ones that provide the freedom, they have -- they are the ones that have inspired me, and they are the ones that we must truly honored each and every day. how great it is that our nation has been one of service, of giving back, and at times we have made mistakes, but one thing is clear -- in this day an era, one thing i have learned

from our vietnam vets is that we will not make those same mistakes again. and this is a prime example of what it is all about -- making sure that the mistakes we made in the past we will not make in the future, and together we can bring change in regard to and how we take care of our service men and women. and i can tell you that this is such a great phonation, and i live in an era where you will remember me and you will honor my sacrifice and help me through recovery. and the thing -- [applause] thank you. and the thing that is so important, as we serve our nation and as we understand freedom's sacrifice, the reason that i showed you those pictures was because it is so important for me bad as i retired from the military, to have a continued

connection. because what happened to me is that at times i lay at brooke army medical center, i am going to be retired, i am going to be out of the military, and i am going to be forgotten. and it was exactly the opposite. that is not what happened. and because of the freedoms and the sacrifices that we have endured, i began my story of what i call challenge, triumph, and change. the challenges sitting on the battlefield almost losing my life. trial is taking the first up after -- triumph is taking the first half after my reputation. and change is learning that with the right support system in place, i could truly a tree greatness. my story starts on january 27, 2003. after serving 14 years on active and reserve status, i got called up to basically train the new

iraqi army. one thing that i understood was that when we go into war, we go as a joint force. and how great it is that i see my fellow brothers and sisters in this room wearing that great uniform, and knowing that as much as i miss it, i could still do my part. and whether we have the army with us, the marines, the air force, the navy, coast guard -- all of us working in that joint environment to ensure that we have the freedoms of this great nation and that we give freedom to nations all over this world. one thing is clear -- our service members know how to stick together and know how to work together as a team. in that joint environment, you may find obstacles on the battlefield that will impede may be our progress for just a little bit, or those pictures of

war and what it looks like. and the reason i show these to the american people is not to glorify this but to say that these are the physical ones that our members come back with. these are the images that they come back with. and whether it is anxiety disorder, depression, hyper vigilance, all of this is clear that when you see these things on the battlefield, at times you bring them back home. and that is one thing that happens to all of us, where the shock and awe of the mission to the tranquillity of what it looks like in baghdad to what we were able to provide for me specifically and those that have served our nation in this great room, whether you have been in this theater of operation or not, one thing for me that was so satisfying is that we gave the iraqi people their freedom. as i embarked on this mission, i

also understood that the people on the ground would also be those individuals that we would begin to develop relationships with. of what may happen to them, those images are forced to live with you each and every day. but also knowing that while we were doing was truly a valuable mission, and whether our politicians did what they are going to do, for us it was about winning and making sure that we accomplished the mission on the ground. and so as we stayed away from the political climate, our job was to provide that support so that they could control their own country and their run destiny and their own future. one thing for me that is very inspiring is that i understand the value of our non-

commissioned officers. they are the reason that i will do the work that i did today. they are the ones that saved my life on that day. i am honored to tell you that because of their work, i am successful because i know i have a goal, and that is to take care of them and not leave them behind on the field of battle. it was my father who asked me to really think about joining the military. the thing that he said to me, a vietnam-era individual, of course, is that you never leave anybody behind in the field of battle. and that is the way that i understand our ngos in the military -- are in ceo's -- nco's in the military.

on an ordinary day come monday would change forever. in and ied, which is called a roadside bomb, or improvised explosive device. this is one of our vehicles coming into them picture and what it means to be attacked by the enemy. [explosion] that is what it looks like to be hit by an ied. on that day, i face the challenges -- i faced the challenges that would change my life forever. i got ambushed. and it was so great that those noncommissioned officers on that day took charge of the situation, secure the perimeter, it got me out of that situation alive, and rendered aid to me. as i sat down at ground on the 103 degree pavement at about 4:00 in the afternoon, the ied

having shattered my leg, i had once across the left side of my body. they pulled me out and laid me down. the first thing that 24-year-old said to me was, major, you are hurt bad. by the way, don't ever tell the patient that. [laughter] but for me on that particular time, the only thing i could think about was my little girl. i thought about it if i died on this day, i am never going to see her again. i would hope that you, the american people, would take care of her. and now that you would. they put me on that helicopter 47 minutes later. i arrived in baghdad for 17 hours of surgery. i got awarded the purple heart by general petreaus. let me tell you the most important thing that happened on that day.

our leader called my family and told them that i would be ok. that is what it is all about. as i embarked on that mission -- people from baghdad to germany to walter reed medical center. i would end up going to brooke army medical center and spending almost 40 days in icu, a total of 18 surgeries, and this is when i felt suicidal. i want to show you this video, because this is what i look like right after this. >> ed pulido leans on two seeder sticks. he will spend the rest of his life leaning on his white. nine weeks ago, of bomb

exploded. >> it is hard to talk about. i could see through my leg. >> he nearly bled to death, and during the next six weeks, if he wanted to live, he had one choice. >> i lost a leg, but that is nothing compared to losing my life. >> of man who once trained iraqi soldiers in the heats can barely carry a lunch tray at a restaurant. it is unbearable without his wife. >> i cannot things up. >> sometimes he can still feel his missing leg. it will help. >> he said his leg was fishing. i reached down on the hospital bed and said, is that better? >> what you going to get dad?

>> of ft. -- 8 ft.. >> it is a smile that could get a dad's heart to mitt -- miss a beat. >> she said, daddy, don't cry. and i tell right cannot help it. >> she said san antonio. that is where they are driving dad to get a prosthetic leg. >> the hardest thing that i have had to go through but i am going to live through it. >> and he will learn to walk again with two of his most important crutches -- his curls. >> wearing that uniform is one thing i will really miss. >> i wanted to show you part of that video, that was said this

-- suicidal ideation for me. it was dark and very troublesome. but it was the american people and the support of the american people that it has helped me, that had given so much for our freedom. they really were the inspirational figures in getting me through that situation. and you have to collect it. one thing was clear that they taught me is that there would be some outlets for me to regain my recovery back. i went snow skiing and actually got a chance to play with the peril of the cocky teen -- their olympic hockey team. it was great to be around these individuals and knowing what my next that in life was. i want to talk through what that

meant for me. one thing was clear -- i had my god with me, my family, my community, and in order to continue to give the bacback i d up with a commander, and a way for us to give back to those who served our nation, we decided to work and embark on a foundation that would provide scholarships. how great it is that we can honor their memory, educate those individuals that have sacrificed so much for our freedom, and understand that we cannot do it alone. the government cannot do it alone. it takes a community, and it takes everyone coming together to make a difference in the lives of all of those who served. and by bringing these key partners to bear, what we're

doing is changing lives, working with the va, working with dod, and so many people did get these individuals out of the golf courses to do the things that they can be inspired to do. mental health recovery is possible because we are able to provide this. my time has been cut short ta today, but i can tell us that our service members have given so much. you are here to provide that support to them. it was interesting because i must tell you that when i was at brooke army medical center, it was general peter pace, the former joint chiefs, who was my inspiration that at a moment time when it was so dark in that hospital room, and i will always remember what he said to me. he said, "major, always remember that on that day you did not lose your leg. on that day you sacrificed it for your country and for

everyone in this nation to be free." today we're here to make sure that when our members come back, that we do not leave them behind for it "would you sacrifice? would you sacrifice your time, your energy, and i ask you to do that, but i also ask you to make a difference in the lives of those that had given the ultimate sacrifice. the last thing i will tell you tis thank you. god bless this great nation. and i salute you. [applause]

>> listen gillan, please welcome the chief medical officer for veterans affairs. -- ladies and gentlemen, please welcome the chief medical officer for veterans affairs. >> good morning. it is a deep honor and gives me great pleasure to introduce the guest speaker. a 1965 graduate of west point, secretary shinseki completed 38 years of uniformed services in the u.s. army, including two combat tours in the republic of vietnam, and served as the army's chief of staff from 1999- 2003. secretaries shinseki became this secretary of veterans affairs in 2009. ladies and showman, secretary of

veterans affairs eric shinseki. >> thank you all very much. they're kind and a very warm welcome. they give for that introduction. short is always best. i am honored to be here. secretary embrey, good to see you. general sutton, great to see you as well. fellow veterans, other distinguished guests, welcome. let me thank secretary gates for hosting this very important conference on suicide prevention. and then for having the great generosity to allow ba to partner with dod -- va to

partner with end. i like to thank ellen embrey for all the work that she is done for so many years strengthening the military health-care system. alan and i overlapped this week as i was finishing my time in the army, the early days of iraq and afghanistan, and it is great to see where you have taken all this. the very best to you and thank you for your leadership in your service. i appreciate this opportunity to address your conference. throughout my years in service in uniform, suicides were one of the most frustrating challenges i face. as i ask mostly of myself but others from time to time, why do we know so much about suicides but so little about how to prevent them?

why do we know so much about suicides and still know so little about how to prevent them? a simple question, but we continue to be challenged, and for that reason i congratulate secretary henry and general sutton as well as my people, and others who are here, for the wisdom of this conference and for their efforts to address the serious problems related to -- and i am speaking of the noncommissioned here -- related to the loss of self-worth and self-esteem and how such fragility can lead to acts of self destruction. of the more than 30,000 suicides in this country each year, fully 20% of them are acts by veterans. that means on average, 18 veterans commit suicide each day. five of those veterans are under

our care at va. so losing five veterans who are in treatment every month and then not having a shot at the other 13 who for some reason have not come under our care, means that we have a lot of work to do. who is vulnerable? everyone. young and old, al gore and reserved, male, female, officer, and listed, me included. will your suffer emotional ones just as they suffer physical ones. -- warriors' suffer emotional wounds justice they suffer physical ones. i am preaching to the choir here. emotional injuries do not lend themselves to physical fixes, but we must continued to -- one

of those splints and patches to help us with the emotionally and mentally injured? when a lot of the causes of suicide, from physiological three dispatchers -- physiological predisposition to those "dear john" letters. recreating the last 721096 hours of a soldier's life was so instructed. where did they go, what was said, what did they do it? a case study usually revealed of multiplicity of signals regarding the individuals intent. company makes, friends, and other units, spouses, significant others, barkeeper's downtown, friends and family back home, all were gifted with

a piece of the puzzle. and not until all the pieces were collected, and usually in aftermath, was the picture completed and signaling what was quite clear. you know that and i know that. the issue is, how do we get better at this? this audience of health care providers, counselors, researchers, and community partners constitutes in military parlance -- i did i get to use it anymore but in your parlance -- our main attack against suicides. you are the experts. you dispense help and hope to those who see themselves as helpless and without hope. i do not think anyone of us can do this alone. if we could, we would be further along. and all of us here today may still not be enough. as this case studies always

informed, there are many other witnesses to the key indicators and pre-suicidal behavior. we are in this together to help the most vulnerable of our people, those in uniform and the veterans who come to us. and as is true of most organized team activities, it is usually better to be on offense than defense. it was about act, react, and counterattack. we tried never to take that first that of acting without knowing what we were going to do in that third step, when counter action was required. that is usually the way that actions go. act, react, counteract. we must build and maintain a strong support system, one in which everyone has a role, where we collectively assume ownership of the problem. it is not someone else's

problem. it is our problem. it does not matter whether there is a uniform or not. it is our problem. we own id. i think the sense of ownership is a critical aspect of the solution. it increases the level of awareness throughout our communities. and in this regard, the military services probably have the edge in compelling ownership by virtue of their highly structured responsibility for reporting and accountability. i used to recall that, and that is what this case studies were about. everyone knows -- everyone knew who owned the issue. it used to be that studies were done to pinpoint roots causes. unit buddies, family members, friends, in a manner of hours,

the last hours of someone's life were recreated as best we could and reviewed, and all too often to the pieces of the question why were collected, it was clear that the warning signs were there. always there, but were messed or not acknowledged in fear of interfering with someone's privacy. that was my experience. to counteract that tendency, training programs like operation save urged participants to get involved and be empowered to do the right thing when they suspect someone is at risk for suicide. speaking for my current role at thva, i think we need to do that which the military has learned so much from. we need to raise awareness of

suicide indicators, not just in our patience but amongst our work forces as well. how do we foster and obtain the goodness of the buddy system that has helped so much in the military and apply it in va among a population of 7.5 million that is all at once disabuse -- diffuse? i believe that it can be done. it may be best and some specific suburbs, those pockets of new veterans now clustering at colleges and universities all across the country. i was just down in florida and got a chance to speak to some student veterans going through school under the new gi bill, about 20 of them. that played pretty good football but they had 10,000 veterans registered for school.

talk about a population, right? i talk to about 20 about them and my primary interest was talking to them about the journey that they were on. i said to them, you know you are all carrying package. immediately i got this pushed back at the table. great to see 20-year-old reacting to a 60-year-old comments. [laughter] you get that arm, the heisman. but we all do -- we all did. you came from a very structured environment where there were first sergeants and company commanders and detachments of supervisory people and now you are here and you're on your room.

-- you're on your own. you see that we're all celebrating you being here on the first day of school but i am looking at graduation rates. if you do not graduate, there is no pay off for this program, so i am entirely interested in your graduation rates. and you are carrying baggage and you're going to have to transition through this. how many of you do your best work after midnight? you come awake about 1:00 in the morning in your powers of concentration seemed to better because you have been dozing in the early hours? maybe one hand went up. how many of you draw your shades in your room down to the windowsill? everyone of them, there is no gap of light. a couple of hands went up. how many of you have anger management problems? a couple of more hands.

how many of you have to read the same paragraph three times before it begins to stick? just about every hand went up. [laughter] i said, welcome to the nfl. you are ok. it's just natural. it is a transition that you will have to go through. it will be helpful if you do it together, help each other. and by the way that youngster not making class, somebody figure out a way to get down the hall, kick him out of the bed, and get in the class. graduation -- that is where i am focused. the old ways of approaching -- approaching mental health and suicide prevention will not work as effectively for the youngsters of the new millennium. i am not sure what that means. but i hear that enough and so i repeat it for you. we are being attentive to that.

they are different from those who came before, and i can tell you that as well. most were born a decade after the last shots were fired in vietnam. they had never used to dial telephone, never watched a black-and-white television, and if you gave them one of those old fashioned can openers, that would probably try weeding your garden. they've never known a world without cellphones, the internet, and is testing -- instant messaging. they talk and act fast because they grew up that way. and so we have to adjust. engaging them requires a new and different model. no longer a desk at an imposing government building but at coffeeshops and on the internet and to a public service announcements they sealed off -- see on a flat screen television or a web site

transforming into a less formal, more open format requires greater collaboration, transparency, and in both our services and our service delivery. i am speaking of an environment where mental health issues in general are demystified, the stigmatized -- the stigmatized -- destimagized, or asking for help as a sign of courage, where there is high quality care, what -- where we identified those with highest risk and do something about it quickly, where emerging treatments and technologies coupled with new drugs advance the success of patient outcome. it is the outcome that we are after. where they do not feel ashamed by there are emotional problems.

and where research is complementary and alternative treatments so that we may determine what of the safest and most effective in relieving suffering and restoring health. how does all that translate from theory into action? we take them to heart and -- in a institute of medicine's 2003 s study calling suicide i national imperative. that drives our overall program as well as the actions we have taken so far and the ones we will take in the future. it is had far-reaching effect for us the inside va. we have expanded our work force enormously, hiring more than 4000 new employees in the last three years, bringing our total mental health enrollment to about 19,000. 400 of them are dedicated

solely to suicide prevention. each of our 153 medical centers and the largest of our 74 outpatient clinics now has a suicide prevention coordinator. it ensures that are at risk veterans receive counseling is a priority. we have extended our outreach to veterans, which in itself has significant life-saving potential pre part of that outreach effort can be seed in a nationwide advertising that some of you may have seen, the campaign on city buses and commuter stations, raising awareness about 24/7 suicide prevention lifelines. we have opened a center of excellence will help center in new york -- mental health center in new york, nice, warm, sunny new york. [laughter]

there we felt this on testing intervention standards for suicide prevention. at our new research center in denver, we are studying the clinical and biological conditions that can lead to increased suicide risks. most notably in 2007, we dramatically improved our prevention program by launching a national suicide hot line. many of you probably know about this but for the few that may not, let me tell you that we partnered with hhs to strengthen our seamless/dod relationship. the opening message on the hot line welcomes both veterans and service members to access counselors and services. the counselors on the hot line are mental health professionals. they do not discriminate between uniformed and non-uniform, and neither do we.

we introduced a chat room for this young degeneration designed to appeal to them. we must continue to leverage opportunities to access and intervene to save the lives of those in distress. after all, there is a standard protocol at every hospital for heart attack victims to come through the doors. there is an established protocol for what you do from the moment that that person walks through the door for it why should potential -- why should some potential suicide victims not be afforded the same thing? dr. janet kemp is the brain behind these initiatives. the partnership for public service presented its 2009 federal employees of the year award for anticipating the

emotional toll was likely to come from all the stresses and a high risk environment that our young combat veterans have gone through. janet, once again, thanks to you. [applause] the people that owe you the biggest vote of thanks are the 5600 or so people who have called in. there are many more that have called in, but there 5600 of them who are in crisis, thinking about suicide, and interventions occurred and they are still with us today. they are the ones that really demonstrate what you have accomplished for less. -- for us. there is no clear-cut -- i have

talked about all the things that were attempted. you will ask how we are doing, and my answer to you would be, we have only just begun. there is no clear-cut answer here. even as the issue of self destruction becomes more complex and changes, we have to adjust. our initiatives are new. we do not have enough hard evidence yet but we think we're headed in the right direction. we can take heart that some of the early emerging trends are encouraging and the data. we know, for example, that since the start, suicide rates have increased -- decreased and veterans that have come to less for health care. the five veterans that have -- that we lose, there are many more that are coming to us for treatment and are suicide rates who are under our care, those

rates have come down. that is a good sign. and despite public perception to the contrary, we do not have any evidence for increased suicide rates among these veterans relative to the veteran population as a whole. where do we go from here? in large measure of this conference, it will help point the way. that is why you are here. deliberations will provide direction for strengthening our current programs and for helping us understand what new programs may be necessary, new programs that are innovative, forward leaning, and with the community base that we operate. the real heroes are those out there in the community that touch our people, and yours and mine, every day. in conjunction with conference of the faculty and staff, you would give us the benefit of your knowledge and experience in

confronting suicide. suicide risk, and leveraging its prevention. i know that by sharing this, both departments, both defense and va, stand to be better positioned to aid the men and women who are struggling to regain the courage to live. struggling to regain the courage to live. and so i am honored to be here and privilege to share this opportunity with ellen embrey in opening today's conference. you have an important and ambitious agenda before you. thanks to all of you for participating. did you for having me here and my great respect -- thank you for having me here and my great respect for the previous speaker. i caught the tail end of his presentation. god bless each of you and each of you who has served our nation, and may god continue to bless our wonderful country.

thank you all very much. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2010] >> up next, a debate for an open u.s. senate seat in massachusetts. after that, senate majority leader harry reid on his "on president obama's race, skin color, and electability. and later, on march 2 pact bar -- bart stupak holds a town meeting. the house returns from its recess on tuesday. the house is by tomorrow noon

eastern third legislative business begins on wednesday. democratic leaders in both chambers hope to work out differences in their two health care bills and bring a similar bill to both the house and senate for vote. watch live coverage of the house on c-span, senate debate on c- span2. the bullet did you know that than #one -- >> d. g. know that the number one -- did you know that the number a onepp is for c-span? it is all free and available app -- crown app. --from the app store. >> and now the massachusetts senate debate. martha coakley, scott brown, an

independent joseph kennedy. the moderator is david gergen. and that the viewers -- joe kennedy is not related to senator ted kennedy who died last summer. >> this coming tuesday will be a crucial time here in massachusetts. voters will go to the polls and select a person who may well determine the outcome of a long fight over health care legislation in washington. at stake it well is jobs, energy, the environment, abortion, the war's oversea. we have much to talk about.

moreover, the candidates are seeking to fill a seat that is legendary in american politics. among the giants of the past, ted kennedy and his brother john, to henry cabot lodge, charge sumner, daniel webster, and john quincy adams. those are some shoes to fill. this debate is sponsored by the edward m. kennedy institute for the united states senate. where it gathered at the boston campus of the university of massachusetts, on whose land the kennedy institute will eventually be built. in an order determined by lottery, let me introduce the three candidates that are with us. scott brown, the republican candidate, is in his third term in the state senate welcoming -- representing the north folk district. martha coakley, the democratic

candidate, was elected in 2006 after serving eight years as district attorney of middlesex county. joseph kennedy, no relation to the late senator, is an independent candidate who was a member of the national libertarian party pretty worse in information technology. in preparing questions, i consulted with members of the media and other peoples whose judgment i trust. the questions themselves are known only to me. to the audience, once again, hold your applause until the end. we will begin with a series of question to the candidate, leaving time for response in discussion. by lottery, the first question will go to mr. brown, and then as quickly -- ms coakley, and then mr. kennedy.

let us begin. president obama and members in congress are now in final -- the final stage of having out a national health-care bill. there is a real possibility that the winner of this election will be in a position to ensure passage of the bill for its defeat. do you want voters in massachusetts to see next tuesday's vote on a referendum on this national health care bill? mr. brown? >> thank you and a pleasure to be here. i think the institute. i thank you for your question. the health care bill being proposed in washington is broken by the bad deal -- by the back room deals. we need to start over. we have health care here in massachusetts. 98% of our people are already insured. we have done it. we do not need what is being pushed in washington on massachusetts, spending $500 million on medicare? we know we need to reform and

that is something we're going to be doing very shortly. to think that we need of one size fits all plan from congress, coming down here and hurting what we have? that is one of the differences between martha coakley and i. at a time when we just do not needed. i would propose going and allowing states to do this individually with the government incentivizing it. we can export what we have done and show them how to do it. i am looking forward to be the party -- the 41st vote and get that plan back to the drawing board. >> thank you for hosting us here this evening. i would be proud to be the 60th vote to make sure that we need health care reform that was so badly need. we have taken the lead here in massachusetts, and now we are attacking the cost to provide competition and transparency to bring the costs down. we spent $2.60 trillion on

health care in this country. we do not get our money. we do not have transparent terry -- transparency in competition. we do not have the kind of health care that we need. senator kennedy said that it is the right and not a privilege. by doing it incrementally is the way that we're going to do it, and we will set the groundwork for the revolutionary way in which we provide coverage for those it cannot get coverage now, making sure that we keep costs down so that people can keep the health care that they have now. >> mr. kennedy. >> the health care bill is a travesty. as much as i would like to think that there's a 41st vote against that, the reality is that we're seeing of votes bought. every time is gone through, we have seen another person failed because they had been bought.